基于观察法的北京市丰台区居家医疗服务研究

A Study on Home Medical Service in Fengtai District of Beijing Based on Observation Method

目的:对北京市丰台区居家医疗服务的政策环境和开展过程进行研究,为相关政策制定提供参考。方法:采用文献法、访谈法、非参与式观察法收集定性定量数据。结果:北京市丰台区具有较好的“国家—市—区”级政策环境,资金补贴及“居委会—社区卫生服务中心双进入”机制,有效推动了居家医疗服务的开展。课题组共观察了28例患者的居家医疗服务,服务提供者以护师为主(70.0%),服务对象以高龄失能、半失能老年人为主(71.5%),服务内容为置换尿管(64.3%)、胃管(28.3%)等安全性较高且适合居家进行的医疗服务。结论:在良好的政策环境下,北京市丰台区居家医疗服务工作取得了一定成效,未来可通过完善医保政策、价格、支付保障机制和建立信息平台,进一步促进居家医疗服务的高质量可持续发展。

OBJECTIVE To analyze the policy environment and service processes of home medical services in Beijing Fengtai District and to provide practical basis for policy development.METHODS Qualitative and quantitative data were collected by litera⁃ture,interview and non-participatory observation.RESULTS Fengtai District of Beijing has a good“state-city-district”level of home medical service policy support environment.Special fund subsidies and the mechanism of“neighborhood committee-communi⁃ty health service center”have effectively promoted the development of home medical services.In the study,28 cases were observed.The service subjects were mainly nurses(70.0%),the service objects were mainly elderly disabled and semi-disabled elderly(71.5%),and the service contents included replacement of urinary catheter(64.3%)and gastric tube(28.3%),which were safe and suitable for home medical services.CONCLUSION Under good policy environment,home medical service work has made a certain progress in Beijing Fengtai District.In the future,we need to further improve the medical insurance policy,establish an Internet information platform and exert its advantages and explore prices and payment security mechanisms,and thus to promote high quality and sustainable development of home health care.